Opioid crisis highlights underbelly of addiction treatment industry

Predatory hotlines run by firms that receive kickbacks for patient referrals. Generic websites that push patients looking for information to inappropriate resources. Poorly regulated providers that give unclear information despite good intentions.

These are among the marketing abuses and problems that patients seeking addiction treatment can face when trying to connect with providers, and the issue is under increasing attention as stakeholders focus on solutions to the opioid epidemic, experts told lawmakers on Capitol Hill on Tuesday.

Concerns about kickbacks and "body brokers" in addiction treatment are not new. A less-insidious form of marketing—incomplete and unclear information—is also common. Marvin Ventrell, executive director of the National Association of Addiction Treatment Providers, said the group has purged several organizations from its ranks in 2018 because they weren't providing information to patients in a way that was up to par. 

Ventrell told legislators on the House Energy and Commerce Committee's Subcommittee on Oversight and Investigations that 24 parent organizations and 99 provider campuses had been booted from the NAATP amid concerns about their quality and marketing tactics. He said the group will launch a guidebook of best practices later this year. 

"What has happened in our industry is among the greatest threats to the success of our work as an addiction treatment field that we have ever seen," Ventrell said. 

RELATED: Backed by medical groups, value-based payments for opioid addiction treatment could be imminent 

Ventrell said the association is monitoring its members for their marketing techniques; for example, members that offer hotlines must make it clear who patients are speaking with when they reach out.

America's Health Insurance Plans said in a statement (PDF) that insurers and other stakeholders' efforts to provide quality addiction treatment to patients "are challenged by fraudulent activity in the substance use treatment industry." 

"These fraudulent, abusive practices not only put patients’ lives in grave danger, but they also make it more difficult for people to afford their coverage and care," AHIP said. "These practices raise overall health system costs and increase premiums for everyone, not just those who are sent to “sober homes.” 

The subcommittee has held multiple hearings on the oversight of treatment centers as legislators work to develop solutions to address the opioid epidemic.  

Ranking member Rep. Diana Degette, D-Colo., said opioid use disorder and addiction are already complicated, and misleading marketing—whether intentional or not—adds another confusing wrinkle to that process. 

RELATED: Pain management needs to go beyond traditional treatment 

The providers at the hearing agreed that the addiction recovery industry likely needs additional oversight and monitoring. Michael Cartwright, CEO of American Addiction Centers, which operates 12 rehabilitation facilities and a hotline, said his organization would welcome additional federal regulation. 

The addiction treatment industry is "maturing," he said, and is thus similar to skilled nursing, which benefited from federal star ratings and other transparency and quality initiatives. 

States such as Tennessee and Florida have enacted legislation that could serve as a model nationwide or at the state level to ensure greater oversight of addiction treatment facilities, he said. 

"I'm glad that Congress is looking into treatment marketing practices," he said. "Treatment providers and government officials should work together let patients and their loved one know who they can trust."